Comparison of Seroma Formation in First 72 Hours with and Without Placement of Gel Foam in the Axilla Following Axillary Dissection
DOI:
https://doi.org/10.54112/bcsrj.v6i7.2293Keywords:
Breast Cancer, Modified Radical Mastectomy, Seroma, Gel Foam, Axillary DissectionAbstract
Seroma formation is a common early postoperative complication following modified radical mastectomy with axillary dissection. Although not life-threatening, it can cause wound morbidity, delay adjuvant therapy, and increase healthcare visits. Various techniques have been proposed to reduce seroma, including quilting sutures, arm immobilization, and pharmacologic agents. Gel foam, a homeostatic and space-occupying material, may reduce dead space and fluid accumulation, but evidence regarding its effectiveness remains limited. Objective: To compare the frequency of seroma formation within the first 72 hours following axillary dissection in patients with and without gel foam placement. Methods: A randomized controlled trial was conducted at the Department of General Surgery, Sir Ganga Ram Hospital, Lahore from 16 November 2024 to 16 May 2025. A total of 124 female patients aged 18–60 years undergoing modified radical mastectomy were enrolled and randomized into two groups: Group A (gel foam, n=62) and Group B (no gel foam, n=62). Baseline characteristics including age, BMI, tumor stage, and number of axillary nodes were recorded. Postoperative outcomes assessed were seroma formation within 72 hours and drain output. Data were analysed using SPSS v25; continuous variables were compared with independent t-tests, and categorical variables were analysed with chi-square tests. A p-value ≤0.05 was considered significant. Results: The frequency of seroma formation was significantly lower in the gel foam group compared to controls (6.5% vs. 17.7%, p=0.04). Both flap and axillary drain outputs in the first 72 hours were significantly reduced in patients receiving gel foam (p<0.001). No significant difference was observed in other postoperative complications, including wound infection, hematoma, or flap necrosis. Baseline characteristics were comparable between groups. Conclusion: Gel foam placement in the axilla following axillary dissection significantly reduces early postoperative seroma formation and drain output without increasing other complications. This simple, safe, and effective intervention may improve postoperative recovery and reduce morbidity in patients undergoing modified radical mastectomy.
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Copyright (c) 2025 Akasha Adnan, Khalid Masood Gondal, Sajeel Ahmed, Ali Akbar, Narmeena Fakhar
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